Many of the pundits have been warning that we could officially enter recession territory later this year or next year, but these numbers seem to indicate that it could happen a whole lot sooner than that. But the stock market has been surging over the last two months, and at this point stocks are off to their best start to a year since 1987, and as long as stock prices are rising a lot of people are simply not going to pay much attention to the economic alarm bells that are ringing. But everyone should be paying attention, because things are really starting to get bad out there.
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Blockchain: Distributed systems
A distributed system is one in which the application and its architecture is distributed over a large number of machines and preferably physical locations. More simply, a distributed system is one where the goal of the system is spread out across multiple sub-systems in different locations. This means that multiple computers in multiple locations must coordinate to achieve the goals of the overall system or application. This is different than monolithic applications, where everything is bundled together.
Let's take the example of a simple web application. A basic web application would run with processing, storage, and everything else running on a single web server. The code tends to run as a monolith—everything bundled together. When a user connects to the web application, it accepts the HTTP request, uses code to process the request, accesses a database, and then returns a result.
The advantage is that this is very easy to define and design. The disadvantage is that such a system can only scale so much. To add more users, you have to add processing power. As the load increases, the system owner cannot just add additional machines because the code is not designed to run on multiple machines at once. Instead, the owner must buy more powerful and more expensive computers to keep up. If users are coming from around the globe, there is another problem—some users who are near the server will get fast responses, whereas users farther away will experience some lag. The following diagram illustrates a single, monolithic code base building to a single artifact:
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Django: Html5 css3 10pages.
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Material: Michael E.Porter ‘s paper named a Strategy for Health Care Reform- toward a value based system issued in Jul.09,2009 the New England Journal of Medicine.
Reflection: what we need now is a clear national comprehensive vision for the kind of health care system we want to achieve and a path for getting there. The central focus shall be increasing value for patients –the health outcomes achieved per dollar spent. Good outcomes that are achieved efficiently are the goal, not the false savings from cost shifting and restricted service. The only way to truly contain costs in health care is to improve outcomes: in a value-based system, achieving and maintaining good health is inherently less costly than dealing with poor health. True reform will require both moving toward universal insurance coverage and restructuring the care delivery system. How can we achieve universal coverage in a way that will support, rather than impede, a fundamental reorientation of the delivery system around value for patients? There are several critical steps. First, we must change the nature of health insurance competition. We must introduce regulation to end coverage and price discrimination based on health risks or existing health problems. In addition, health plan shall be required to measure and report their subscriber’s health outcomes, starting with a group of important medical conditions. Second, we must keep employers in the insurance system; third, we need to address the unfair burden on people who has no access to employers-based coverage who therefore face higher premiums and greater difficulty on securing coverage. Fourth, to make individual insurance affordable, we need large statewide or multistate insurance pools, fifth, income-based subsidies will be needed to help lower income people to buy insurance, finally once a value-based insurance market had been established, everyone must be required to purchase the insurance so that young and healthier people could not opt out. For restructuring the delivery system where most of the value is created and most of the costs are incurred. First, measurement and dissemination of health outcomes shall become mandatory for every provider and every medical conditions. Second, we need to radically reexamine how to organize the delivery of prevention, wellness, screening and routine health maintenance services. Third, we need to reorganize care delivery around medical condition. Fourth, we need a reimbursement system that aligns everyone’s interests around improving value for patients. Fifth, we must expect and require providers to compete for patients, based on value at the medical-condition level, both within and across state borders. Sixth, electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Finally consumers must become much more involved in their health and health care. Michael port did not mention why this is the right strategy.